We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Expanding Scope of State Legislation

Fred J. Hellinger, PhD
JAMA. 1996;276(13):1065-1070. doi:10.1001/jama.1996.03540130063031.
Text Size: A A A
Published online


EACH YEAR dozens of bills that govern the activities of managed care plans are introduced in state legislatures. Often, opponents refer to these as "anti-HMO," "anti—managed care," or "anticoordinated care," and supporters refer to them as "patient protection acts" or "fair managed care acts."

Some of these bills ensure enrollees direct access to certain types of medical specialists without the need for a referral from their primary physician, and others ban exclusive relationships between health plans and physician providers. In addition, more than a dozen bills were introduced in state legislatures in 1995 that set minimum lengths of hospital stays for deliveries.

This study traces the growth of 3 types of state laws that regulate managed care plans (direct-access laws, laws that prohibit exclusivity clauses, and laws that mandate minimum lengths of stay for deliveries). Arguments advocating and resisting these laws are examined along with information about their impact on


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.